Melissa Mercedes Carder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P160235990 Issued in WA

Practice address

1520 Pleasant St
Walla Walla, WA 99362-3738

Phone

(509) 979-0838

NPI assigned

Jun 15, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Melissa Mercedes Taylor Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mcarder@esd123.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1295465953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MOUNTAIN PARK DR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621533",
            "telephone_number": "509-979-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 PLEASANT ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623738",
            "telephone_number": "509-979-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDER",
        "first_name": "MELISSA",
        "middle_name": "MERCEDES",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160235990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "P160235990",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MCarder@esd123.org",
            "affiliation": "N",
            "address_1": "1520 Pleasant St",
            "city": "Walla Walla",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993623738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "TAYLOR",
            "middle_name": "MERCEDES",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick Andrew Calvo, LMFTA
• Cameron Stewart DDS LLC
• Perry E Camp, MD
• Cheryl Ann Campbell, LICSW, CDP
• Michelle I Cardenas, MSW
• Catherine Carlin
• Katharine Carlisle, CCC-SLP
• Anna Fay Carlson, L.M.P.
• F. Joan Carman, RN
• Robert W Carmody, M.D.

• Physical Therapy Assistant in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.